Macular degeneration is one of the leading causes of vision loss in people over the age of 50. It impacts the macula, the central part of the retina responsible for seeing fine detail. Over time, macular degeneration can make everyday tasks like reading, driving, and recognizing faces difficult or even impossible. Although there’s no outright cure, there are several treatment options available, including surgery in advanced cases, that can help manage the condition, slow its progression, and preserve vision for longer.
What Is Macular Degeneration?
Macular degeneration, also known as age-related macular degeneration (AMD), is a chronic eye disease that affects central vision. It does not typically cause complete blindness, but it severely impairs tasks that require sharp focus. The disease can progress slowly or rapidly, depending on the type.
The exact cause isn’t fully understood, but contributing factors include genetics, smoking, high blood pressure, obesity, and prolonged exposure to ultraviolet light. It’s important to diagnose AMD early so that lifestyle changes and treatments can be started to slow progression.
The Two Types: Dry vs. Wet AMD
Dry Macular Degeneration (Atrophic)
Dry AMD is the most common form, affecting about 8 out of 10 people with the condition. It is caused by the gradual thinning of the macula and the buildup of small deposits called drusen. Vision loss is typically slow and may go unnoticed at first, though it can become significant over time.
Wet Macular Degeneration (Neovascular)
Wet AMD is less common but more serious. It occurs when abnormal blood vessels grow under the retina and leak fluid or blood, causing rapid damage to the macula. This type can lead to sudden and severe vision loss and requires immediate attention.
Comparison of Treatment Options for Dry vs. Wet AMD
| Treatment Option | Dry AMD | Wet AMD |
| AREDS2 Nutritional Supplements | Yes – slows progression in intermediate stages | No direct benefit |
| Lifestyle Adjustments | Yes – improves eye health and slows damage | Yes – helps support overall treatment effectiveness |
| Anti-VEGF Injections | Not applicable | Yes – main treatment to block blood vessel growth |
| Laser Photocoagulation | Not used | Yes – seals leaking vessels |
| Photodynamic Therapy (PDT) | Not used | Yes – used for certain types of wet AMD |
| Miniature Telescope Implant | Yes – for severe cases in one eye | Rarely used |
| Vitrectomy | Rarely needed | Sometimes – for complications like hemorrhaging |
When Is Surgery Considered?
Surgical treatment is typically considered for wet macular degeneration when:
- Other treatments, such as injections, are not working effectively.
- There is substantial bleeding or scarring under the retina.
- Additional retinal conditions complicate AMD, such as retinal detachment.
Surgical procedures can vary depending on the patient’s needs and the progression of the disease.
Preparing for Macular Degeneration Surgery
Before surgery, you’ll undergo several diagnostic tests to assess the severity of your age-related macular degeneration (AMD). Your ophthalmologist may perform Optical Coherence Tomography (OCT) to scan the layers of your retina, fluorescein angiography to detect any leaking blood vessels, and visual acuity tests to measure how well you see. Additionally, you may be asked to stop taking blood-thinning medications, avoid food or drink for several hours before the procedure, and arrange for someone to drive you home afterward.
What to Expect During Surgery
There are several procedures that may be performed, depending on your condition:
1. Anti-VEGF Injections
Although not considered traditional surgery, anti-VEGF (vascular endothelial growth factor) injections are a cornerstone treatment for wet age-related macular degeneration (AMD). These injections are administered directly into the eye, typically on a monthly or bi-monthly basis, depending on the patient’s response. Anti-VEGF medications—such as Lucentis, Eylea, or Avastin—work by blocking VEGF, a protein that promotes the growth of abnormal and leaky blood vessels under the retina. By inhibiting this process, the injections help reduce fluid buildup, prevent further vision loss, and in many cases, even improve visual acuity. The procedure is usually quick, performed in a clinical setting, and involves numbing the eye to minimize discomfort.
2. Laser Photocoagulation
A high-energy laser targets and seals leaking blood vessels to prevent further damage to the macula. The procedure is quick and typically performed in an outpatient setting.Laser photocoagulation is a treatment option primarily used for certain cases of wet age-related macular degeneration (AMD). In this procedure, a high-energy laser is precisely aimed at the abnormal blood vessels that are leaking under the retina. The laser effectively seals these vessels, preventing further leakage and reducing the risk of additional damage to the macula—the central part of the retina responsible for sharp, detailed vision. While the procedure does not restore vision that has already been lost, it can help stabilize the condition and prevent further deterioration.
3. Photodynamic Therapy
This treatment uses a light-sensitive drug called verteporfin, injected into the bloodstream. Once the drug reaches the abnormal blood vessels in the eye, a cold laser activates it, damaging and closing the vessels. PDT slows vision loss and is typically used when anti-VEGF injections aren’t enough. The procedure is painless and done in-office, but patients must avoid bright light for 48 hours afterward.
4. Vitrectomy
Vitrectomy is a surgical procedure used when there’s severe bleeding or scarring in the eye. It involves removing the vitreous gel to access and repair the retina. This helps clear vision blocked by blood or scar tissue. It’s more invasive than other AMD treatments and requires a longer recovery period, but it can be effective in complex cases.
Recovery and Post-Surgery Care
Recovery after treatment for wet age-related macular degeneration varies depending on the type of procedure performed. It’s common to experience mild discomfort, redness, and sensitivity in the eye following treatment. Vision may remain blurry for several days or even weeks as the eye heals. Regular follow-up visits with your eye specialist are essential to monitor progress and make any necessary adjustments to your treatment plan. You may also be prescribed eye drops to help prevent infection and reduce inflammation. For patients who undergo a vitrectomy, recovery can be more involved and may require keeping the head in a specific position for extended periods to promote proper healing of the retina.
Possible Risks and Complications
As with any eye surgery, there are potential risks involved. These may include retinal detachment, eye infection, bleeding, elevated eye pressure, and the formation of scar tissue. While these complications are relatively rare, it’s important to be aware of them. Your eye doctor will explain these risks in detail before the procedure and take every precaution to minimize them and ensure a safe recovery.
Can Macular Degeneration Surgery Improve Vision?
Surgery and treatment can significantly slow or halt the progression of AMD, especially in wet cases. While these procedures do not reverse damage already done to the retina, some patients may experience mild vision improvement or better clarity. The key goal is to preserve the vision you still have and prevent further deterioration.
Protect Your Vision with Expert Care from Vision Gallery
Macular degeneration can feel overwhelming, but you don’t have to face it alone. At Vision Gallery, our experienced team offers personalized care tailored to your condition. Whether you need advanced diagnostics, treatment options, or surgical care, we’re committed to helping you maintain your vision and quality of life.
Book your consultation today and take the first step toward clearer vision and better eye health, Vision Gallery is here for you.
